Plan G costs around $180/month but covers Part B excess charges; Plan N runs roughly $140/month but adds copays. The difference can exceed $1,200 a year.
Samuel Owens, a 47-year-old fire captain in Columbus, Ohio, earning around $89,000 a year, thought he had Medicare figured out. He almost enrolled in Plan G on the spot after a broker told him it was the 'best' plan. But something made him hesitate — the monthly premium was roughly $185, and he wasn't sure he'd ever use enough care to justify it. He started digging into Plan N, which ran about $145 a month, but worried about the $20 copays for doctor visits and the $50 emergency room charge. That hesitation saved him from a decision he might have regretted. The difference between these two plans isn't just about monthly premiums — it's about how you actually use healthcare.
According to the Kaiser Family Foundation's 2026 Medicare chartbook, roughly 30% of beneficiaries choose Plan G, while Plan N accounts for about 12%. This guide covers three things: the exact coverage differences, the hidden costs most people miss, and a step-by-step framework to pick the right plan for your situation. In 2026, with Medicare Advantage enrollment climbing and Part B premiums rising, understanding the trade-offs between Plan G and Plan N matters more than ever.
Samuel Owens, a fire captain in Columbus, Ohio, first heard about Medigap plans from a colleague. He was turning 65 and knew Original Medicare (Part A and Part B) left gaps — deductibles, coinsurance, and the 20% Part B copay that has no cap. He looked at Plan G first because it's the most popular Medigap plan, covering nearly everything except the Part B deductible ($240 in 2026). But when he saw the monthly premium — around $185 — he paused. 'That's $2,220 a year before I even see a doctor,' he thought. He then looked at Plan N, which runs roughly $145 a month but requires copays of up to $20 for office visits and $50 for emergency room visits. He wasn't sure which one made sense for someone who rarely goes to the doctor but wants protection from a catastrophic event.
Quick answer: Plan G covers all Medicare gaps except the Part B deductible, while Plan N covers the same except it requires copays for certain visits and does not cover Part B excess charges. In 2026, Plan G premiums average around $180/month and Plan N around $140/month (Kaiser Family Foundation, 2026 Medicare Chartbook).
Plan G covers Medicare Part B excess charges — the difference between what Medicare approves and what a provider charges. If a doctor does not accept Medicare assignment, they can bill up to 15% more than the Medicare-approved amount. Plan G pays that extra 15%. Plan N does not. In 2026, roughly 5% of doctors nationwide do not accept assignment, but in some states like Ohio, that number is closer to 8% (CMS, Medicare Participation Report 2026). If you see a specialist who doesn't accept assignment, a single visit could cost you an extra $30 to $100 under Plan N.
Many assume Plan N's copays are tiny and rare. But if you have a chronic condition requiring monthly specialist visits, those $20 copays add up. At 12 visits a year, that's $240 — narrowing the premium gap between Plan G and Plan N to roughly $240 a year. Factor in one ER visit with a $50 copay, and the gap shrinks further. The real difference isn't the monthly premium — it's how often you use care.
| Feature | Plan G | Plan N |
|---|---|---|
| Part A coinsurance + hospital costs | 100% | 100% |
| Part B coinsurance | 100% | 100% (except copays) |
| Part B excess charges | 100% | 0% |
| Office visit copay | $0 | $20 |
| ER copay | $0 | $50 (waived if admitted) |
| Foreign travel emergency | 80% | 80% |
| Average monthly premium (2026) | $180 | $140 |
In one sentence: Plan G offers full coverage with no copays; Plan N trades lower premiums for copays and no excess charge protection.
For a deeper look at how healthcare costs fit into your broader financial picture, see our Plan for Early Retirement Financial Independence Guide.
Another key difference is how these plans are priced. Plan G is typically community-rated or attained-age rated, meaning your premium doesn't increase as you age (or increases only with inflation). Plan N is often issue-age rated, so your premium is based on the age you enroll. If you enroll at 65, your rate stays lower than someone who enrolls at 75. But if you enroll later, your base rate is higher. In 2026, a 75-year-old enrolling in Plan N for the first time might pay 30-40% more than a 65-year-old on the same plan (American Association for Medicare Supplement Insurance, 2026 Rate Survey).
In short: Plan G gives you predictable, comprehensive coverage with no surprises, while Plan N saves you roughly $40/month but exposes you to copays and potential excess charges.
The short version: You have 3 steps: (1) determine your Medigap Open Enrollment window, (2) compare quotes from at least 5 insurers, and (3) decide based on your expected healthcare use. Total time: roughly 2-3 hours. Key requirement: you must be enrolled in Medicare Part A and Part B.
The fire captain from Columbus learned this the hard way. He waited until he was 66 to start comparing plans, not realizing his Medigap Open Enrollment Period — a 6-month window that starts the month he turned 65 and enrolled in Part B — had already closed. Outside that window, insurers can use medical underwriting to deny coverage or charge higher rates based on pre-existing conditions. He ended up paying around $210 a month for a Plan G policy because of a minor heart condition, roughly $30 more than the standard rate. 'I should have done this at 65,' he said. 'I cost myself around $360 a year.'
Your Medigap Open Enrollment Period is a one-time, 6-month window that begins the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this window, insurers cannot deny you coverage or charge higher premiums due to health conditions. If you miss it, you may face medical underwriting. In 2026, roughly 15% of applicants outside their open enrollment window are denied coverage (Kaiser Family Foundation, 2026).
Medigap plans are standardized — Plan G from one insurer offers the same coverage as Plan G from another. But premiums vary widely. In Columbus, Ohio, Plan G premiums in 2026 range from around $155/month with Mutual of Omaha to $210/month with Aetna. Plan N ranges from roughly $125/month with State Farm to $175/month with Cigna. Use a site like Bankrate's Medigap comparison tool to get quotes from at least 5 insurers.
Most people only compare premiums. But you should also check each insurer's rate increase history. Some companies raise premiums by 5-8% annually, while others keep increases under 3%. Request the last 5 years of rate increases from each insurer. A $155/month plan that increases 8% a year will cost more over 10 years than a $170/month plan that increases 3% a year. The difference can exceed $1,500 over a decade.
Use this simple framework to decide:
Step 1 — Gauge your usage: How many times do you visit a doctor per year? If 6 or fewer, Plan N likely saves you money. If 12 or more, Plan G may be cheaper.
Step 2 — Assess excess charge risk: Do you live in a state where many doctors don't accept assignment? Check your state's rate at CMS.gov. If above 5%, Plan G is safer.
Step 3 — Project your future: Are you healthy now but have a family history of chronic conditions? Plan G locks in predictable costs. Plan N's copays can add up as you age.
| Insurer | Plan G Monthly Premium | Plan N Monthly Premium | Rate Increase History (5yr avg) |
|---|---|---|---|
| Mutual of Omaha | $155 | $125 | 3.2% |
| Aetna | $210 | $165 | 4.1% |
| State Farm | $175 | $125 | 2.8% |
| Cigna | $195 | $175 | 5.0% |
| Blue Cross Blue Shield | $200 | $155 | 3.5% |
For a broader view of how healthcare costs affect your retirement planning, see our Passive Investing for Beginners USA 2026 guide.
Your next step: Visit Medicare.gov's Medigap page to check your open enrollment status and get official plan information.
In short: Enroll during your 6-month open enrollment window, compare 5+ insurers by both premium and rate increase history, and use the GAP framework to match your healthcare usage to the right plan.
Hidden cost: The biggest trap is the Part B excess charge exposure under Plan N. If you see a non-assignment doctor, you could pay up to 15% more per visit. In 2026, that can add $200-$500 a year depending on your provider network (CMS, Medicare Participation Report 2026).
If your doctor does not accept Medicare assignment, they can charge up to 15% above the Medicare-approved amount. Plan G covers this. Plan N does not. In 2026, roughly 5% of doctors nationwide do not accept assignment, but in states like Ohio, Florida, and Texas, that number is closer to 8-10% (CMS, 2026). If you see a specialist twice a year and each visit has a $50 excess charge, that's $100 a year you wouldn't pay under Plan G.
Yes. The $20 office visit copay and $50 ER copay seem small, but they compound. If you have a chronic condition like diabetes or heart disease, you might see a specialist every month. That's $240 a year in copays. Add one ER visit that doesn't result in admission — $50. Now you're at $290 a year. Compare that to the $480 annual premium savings of Plan N over Plan G ($40/month × 12), and your net savings drop to around $190. If you have 15+ visits a year, Plan N can actually cost more than Plan G.
If you're leaning toward Plan N, ask every doctor you see whether they accept Medicare assignment. Do this before you enroll. If even one of your regular providers doesn't, the excess charge risk alone may justify paying for Plan G. The difference is roughly $40/month — about the cost of one copay-heavy visit.
Both Plan G and Plan N cover 80% of foreign travel emergency care, up to plan limits, for the first 60 days of your trip. But there's a trap: you must meet a $250 deductible per year before this coverage kicks in. If you travel internationally once a year, this deductible effectively reduces your coverage. For frequent travelers, this can be a hidden cost. In 2026, the average foreign emergency claim is around $2,000, meaning you pay $250 plus 20% of the remaining $1,750 — roughly $600 out of pocket (Medicare Rights Center, 2026).
Medigap plans are guaranteed renewable as long as you pay premiums, but they are not portable across all insurers in the same way. If you move to a state where your insurer doesn't offer Medigap policies, you may need to switch plans. In that case, you could face medical underwriting if you're outside your open enrollment window. In 2026, roughly 12% of Medigap applicants who move states are denied coverage or face higher rates (Kaiser Family Foundation, 2026).
| Fee Type | Plan G | Plan N |
|---|---|---|
| Part B excess charge (per visit) | $0 | Up to 15% of Medicare-approved amount |
| Office visit copay | $0 | $20 |
| ER copay | $0 | $50 (waived if admitted) |
| Foreign travel deductible | $250/year | $250/year |
| Annual premium (avg) | $2,160 | $1,680 |
In one sentence: The hidden cost of Plan N is the combination of copays and excess charges that can erase its premium advantage for frequent healthcare users.
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In short: Plan N's lower premium can be offset by copays and excess charges if you use healthcare frequently or see non-assignment doctors, making Plan G the safer choice for heavy users.
Bottom line: Plan G is worth it if you visit a doctor 12+ times a year, have a chronic condition, or live in a state with high non-assignment rates. Plan N is worth it if you are healthy, visit a doctor 6 or fewer times a year, and are willing to accept copays for the chance to save roughly $480 a year.
| Feature | Plan G | Plan N |
|---|---|---|
| Control over costs | High — predictable premiums, no copays | Medium — lower premium but variable copays |
| Setup time | Low — enroll once, no ongoing decisions | Low — same as Plan G |
| Best for | Frequent healthcare users, chronic conditions | Healthy individuals, low healthcare utilization |
| Flexibility | High — any doctor, any visit, no copays | Medium — must consider copays and excess charges |
| Effort level | Minimal — set it and forget it | Low — but need to track copay spending |
✅ Best for: Seniors with chronic conditions (diabetes, heart disease) who visit specialists monthly; retirees who want predictable, all-in-one coverage without surprises.
❌ Not ideal for: Healthy 65-year-olds who rarely see a doctor and want to minimize monthly premiums; those willing to accept some out-of-pocket risk for lower upfront costs.
Let's do the math. Over 5 years, Plan G at $180/month costs $10,800. Plan N at $140/month costs $8,400 — a savings of $2,400. But if you have 12 office visits a year ($240/year in copays) and one ER visit every other year ($25/year average), your total out-of-pocket under Plan N is roughly $1,325 over 5 years. That reduces your net savings to around $1,075. If you have 24 visits a year, Plan N's copays alone hit $2,400 over 5 years, wiping out the savings entirely.
If you are healthy and disciplined, Plan N saves you money. If you have any chronic condition or uncertainty about future health, Plan G is the safer bet. The difference is roughly $40/month — the cost of one restaurant meal. For most people, the peace of mind of Plan G is worth it.
What to do TODAY: Check your Medigap Open Enrollment status at Medicare.gov. If you're still in your 6-month window, get quotes for both Plan G and Plan N from at least 5 insurers. Use the GAP framework to decide. If you're outside your window, apply anyway — some states have guaranteed issue rights in certain situations.
In short: Plan G is the safer, more predictable choice for most people, but Plan N can save you around $1,000 over 5 years if you are healthy and rarely use healthcare.
No, Plan N does not cover Part B excess charges. If your doctor charges more than Medicare's approved amount, you pay the difference — up to 15% extra. Plan G covers this completely.
Plan G premiums average around $180 per month in 2026, but range from $155 to $210 depending on your insurer, location, and age at enrollment. Rates vary significantly by state.
Choose Plan G. The $20 copays under Plan N add up quickly with frequent visits — 12 visits a year cost $240 in copays alone. Plan G's predictable premium is almost always cheaper for chronic conditions.
You lose guaranteed issue rights. Insurers can then deny coverage or charge higher premiums based on your health history. Roughly 15% of applicants outside the window are denied (Kaiser Family Foundation, 2026).
Yes, if you visit a doctor 6 or fewer times a year and accept the risk of excess charges. Plan N saves roughly $40/month, or $480/year, which usually outweighs the copay costs for low healthcare users.
Related topics: Medicare Supplement Plan G, Medicare Supplement Plan N, Medigap Plan G vs Plan N, Plan G cost 2026, Plan N copays, Part B excess charges, Medigap open enrollment, best Medigap plan, Medicare Supplement comparison, Medigap rates by state, Plan G vs Plan N for seniors, Medigap for chronic conditions, Medicare Supplement Ohio, Medigap rate increase history, Plan G vs Plan N calculator
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